EVERGREEN HEALTH CO-OP (149) PAYER (365.12)
Name
Value
PAYER NAME
EVERGREEN HEALTH CO-OP
VA NATIONAL ID
VA2580
EDI ID NUMBER - PROF
45319
EDI ID NUMBER - INST
45319
APPLICATION
EIV
NATIONALLY ENABLED: Enabled
*AUTO-ACCEPT: NO
*IDENT REQUIRES SUBSCRIBER ID: YES
*TRANSMIT SSN: NO
DATE/TIME CREATED: 2016-10-28 15:06:20
*FUTURE SERVICE DAYS: 9999
*PAST SERVICE DAYS: 9999
AUTO-UPDATE: NO
270 REQUIRES SUB ID: YES
FUTURE SERVICE DAYS: 9999
PAST SERVICE DAYS: 9999
